19202 76TH AVE W.PDFIIIIIIIIIIII
6261
19202 76TH AVE W
ADDRESS: I qcgoa - 104 Ru, bi
TAX ACCOUNT/PARCEL NLTM13ER: c�2—/Oq - / W-Oqo -5q
BUILDING PERMIT (NEW STRUCTURE): I q-7-?-0U60
COVENANTS (RECORDED)
CRITICAL AREAS - DETERMINATION: F1 Conditional Waiver []StudyRequired
.�aiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER.): 0 01015 C-70,M
PLANNING DATA CHECKLIST DATED: 511116 -5
SCALED PLOT PLAN DATED: -
SEWER LID FEE $: LID
SHORTPLAT
SIDE SEWER AS BUILT DATED: /D/E/7-7
'54
SIDE SEWER PERMIT(S) #:—
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DA'
OTHER:
LOT: BLOCK:
LATEMP\DSrs\Forms\Street File Checklist.doc
CA File No:.
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/ vegetation)*
Site Address/ Location: Wesil
2. Property Tax Account Number: .2 -264 1 EM -4,6.K'4 OC2
3. Approximate Site Size (acres or square feet): �5 M
4. Is this site currently developed? k yes; _ no.
If yes; howis site devel * ed?51N�J�_
OP
5. Describe the general site topography. Check all that apply.
Flat- less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise.of 10-feet over a horizontal
distance of 66-feet).
Hilly: slo pes present on site of more than 15% and less than 30% (a vertical rise of 1 0-feet
over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% t
pr
M40 1M&C�6v6r a, horizont�l
distance of less than 33-feet) No:
A .
71 ;'i'i U
Other (please describe): PAR
Z
VT_J Y; i1a
6. Site contains areas of year-round standing water: Ap'p'r'ox. Depth:
Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in fhe floodway 4 1 - floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs n-dxed
urban landscaped (lawn, shrubs etc)
11. Obvious wetland is present on site: 44!�L
.1
For City Staff Use Only
1. Plan Check Number, if applicable?
2. Site is Zoned?
3. SCS mapped soil type(s)? AL-11---') 5L_vYE5
4. Critical Areas inventory or C.A. map indicates Critical Area on site? 1-1-0
5. Site within designated earth subsidence landslide hazard area? _t-vo
DETERMINATION
STUDY REQUIRED WAIVER
Reviewed br. Da'fp! YlYlb 9:--.
Critical Areas Check] ist.doc/4.22.2003
0
0
0? ED_Af
A � 1 *1 Ok+
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
10c. %91� Fax: 4251.771.0221
.Date Received: —t -n( I U ':�)
City Receipt#:, 7
Critical Areas File M
Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant:
The Critical Areas Checklist contained on this form is to A property owner, or his/her authorized representative,
be filled out by any person preparing a Development must fill out the checklist, sign and date it, and submiit it
Permit Application for the City of Edmonds prior to . to the City. The City will review the checklist, make a
his/her submittal of.the applicat.ion--to th-e-.Ci.ty-.--------.—.--_precursory site. visit, and make a determination of the
The purpose of the Checklist is to enable City staff to subsequent steps necessary to complete a development
determine whether any potential Critical Areas are, or permit application.
may be, present on the subject property. The information Please submit a vicinity map, along with the signed copy
needed to complete the Checklist should be -easily of this form to assist City staff in finding and locating the
available from observations of the site or data available at specific piece of property described.on this form. In
s, or soil addition, the applicant shall include other pertinent
11ftmum—
S=MW #ANT information (e.g. site plan, topography map, etc.) or
MW studies in conjunction with this Checklist to' assistant staff
APPLIN77r)-m- vr si�-3vnm,/ f I in completing their preliminary assessment of the site.
The undersigned applicant, and hisA_e_r7its`7eirs_
a�a"79!11M,in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonabl
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate
incomplete information furnished by the applicant, his/her/its agents or employees. 018
By my signature, I certify that the information and exhibits herewith subn-dtted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPLicANT/AGENT — :�ba I �ejc%.&Q P DATE\�,� ?pb:�
Property Owner's Authorization
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER DATE'�&��O O�.
PLEASE PRINT CLEARLY
Owner/Applicant: Applicant Representative:
Me
C? S, -K 1;7 P__00�rr
Street Address
Jim C?aq_i�, �2
city' State Zip
Telephone: 4Z 9 69:1.2 -(acf 4z _3
Email address (optional): m+y-,4ckx <m CopA
Name
Street Address
city State Zip
Telephone:
Email Address (optional):
Critical Areas Checklist.doc/4.22.2003
00
RECEIVED
JUL 3 12003
PERMIT COUNTER
z -i
,TREET FILE
LOT LINE STAKES N!,,
BE IN PLAL; AT TIW"
[Tate:
7 T1 �Lvl�t-a � �7-
ZONE 82- --5
SETBACKS:
FRONT 2!2
SIDE -7. =
REAR 1
OTHER
HEIGHT—�2—�—
APPROVED BY PLANNING APPROVED AS NOTED
BY ENGINEERING
2'VZO-P OucrhPn�
f Lwcjf� SLUT vopcir- f(s
14EqW?-*X> PMOU00 ft%ZgPr
Of'- 'DMIUSBA10M.
Gavq�,-,- AcH+ir)
— /Z Cc- Y26R
To CONNECT
Z.
YWNER/CONTRACI-0,9 IS RESPONSIBLE
-"FOR EROSION CONTROL AND DAMAGE
-Fot.� Lc.+- P%.f e ck = 13, <806 cl
-T-rqpe v6OU-5
'Aftq'ous Am* (w4.uolm& VmFwefttm&� - -ZW4 6
Ey, I s+- I , h I +'10 n
'Pave-4 Roq� E-ase-rqp-vit ZA 3U? z/
'Resicle m.c e Z, IS-3
CpswT tan
e7V 66 c� '7S7,
ex%ST.
4 F4-
Rr 113
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APPROVED BY PLANNING
h 4-- 4of
R.4
00
CD
STREET FILE
Q'sa 10
RECEIVED
AUG - 6 2003
PERMIT COUNTER
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tr.
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PLANNING DATA
REDUCED SITE PLAN PROVIDED?: (Yes / No
MAP PAGE:_*130& CORNER LOT: (Yes FLAG LOT: QLeL�o
ZONING: —15 CRITICAL AREAS DETERMINATION #:
L) Study Required:
;UiNaiver
UConditional Waiver
SEPA DETERMINATION:
Ll Fee
LJ Checklist
OAPO list w/ notarized form
U (Needed for 500 cubic Yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Bal llin'ger)
PIE,empt ,e 50
SETBACKS:
Required Setbacks: f
Street: *2 ar:
12- LeftSide: Right Side: Re
Actual Setbacks-
Stre;7&
. L.-V I aft Side: Right Side: Rear:
Street map checked for additional setback required? (Yes / No DNA)
DETACHED STRUCTURES-
13 FEI�E
NC_� ELLISES:
W OW
L3 B IND�
A WINDOW PRQJ_ECTING MODULATION:
STAIRS / DECKS:
PARKING:, Required: Actual:
LOT AREA:
LOT COVERAGE -
BUILDING HEIGHT: I
__fL� 421---jaitu
Datum Point: P"'IAK W4�*I_CA1 rn Elevation:--t— I CIO
Maximum Allowed:--;7, EZ 4 Actual Height: ///Z--7. ZS;7
A.D.U. CREATEDIQA�esj
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: CYes o
OTHER:
Plan Review By:
NewBPPIanningDataForm.D0C
0 J��
Ak7
MIT
zo UMBER
1-T..",UDD
BURDING DEPARTMM
ApplicantFil;
PERMIT APPLICATION
Inside Heavy Lines
'oo
DDR= _-�
NAME (OR NAME OF BUs."'Essi
—1p
'.""L
LEGAL LIT
SUB17IIV -!ON �0.
wr'-ILiNG ADDRESS
So 61-5
ING STR�CT �.'jw (f�4.0 T. DEFIC:ENCY THIS PROPERTY
o
CITY
�FE_:LEPH_ E NUMBER
PLAN %7r. R FT.
7-2 -;rj' '2 6".
CGNIP.
_N WIF
DA
R&AARKS 'Jr!Ve1qL3j SiUPT-ML L6 U.=Ld_thTML�_ 'z'
A
indicated on Standard Drawing #103.
ADURE515
17m)
Is
ANDIO.' VTII_ITY �70_.K _7W
M.M1 REQUIRED z
w
=ICITI
D.
lipycs b NO
6 YES IoNo
N—le
v...w_.ov.D
ING ONO
- kt e r s -I
TYPE CONNEC7KRI
�ERI ED By
0
I_
ADURESS
SANITARY �EYICR 0
C,
I (k
<1
c76U, i"
SE, 5 —'r. y
J�PER.t`r NUMBER
E
I.
z
ITY
...... ONE NUMBER
APPV'D By cl,Y ENG.
o
o
7-V -'J ?/2
u
-31 e.
—7
CITY LICLN5C W
ETE. WZE :E
Legal Dercription of Property (Sho- P�lcw. � :.tt=l, Four Coq;n)
'IGN AREA
TNv.
AD1 No.
A LLCE�i
:"otl
COMPLETE
ExIDAPT
I
0
j
i
pill"
vA;7tANcE on cu
PFF=
T��
-
7 7
YARDS
'7�ISIOE
)5_1FRONT
REAR�
NEW
FIRE Z�E
PTIFE OF co�scyjzim
CODE
`77-3
It---Z.! ... TI-1
E].I--
ADD
RETAINING
'7ENC9
SPECIAL INSPECTOR
Rzokn
12C
G
LOAD
—CAVATE
ALL
VVIIED
N.
J_ (*-
--.R
OR FILL
X—IFT)
�:rt C. co
THIS SITE
IS LOCATED I N THE
CP
.""R
....ov.
Is:?%
swim
POOL
j OF EDMONDS. LOCAL !MES TA
SHOVL2� BE CODED 31.04.
"UMOEM OF STORIES
WKLLING
NATURE. Of WORK TO be DONE
I.
z
L
0
Par.
PROPOSED use
PLAN CWCCK
t�T'
.27
0
Fdy jT61aC;Z1. ..T.ACKS.
z
AOUTTING STREETS)
BUILDING
7 6
�73 7 6
0
PLUMBING
J
W,
L,T & GAS LINE
a
FENCP.
z
SIG.
RETAINING WALL
0
SWIMMING POOL
TOTAL AMOUNT DUE
76 6��-
I hereby acknowledge that I have mad thit ap;iLication; the in-
formation gi�,rn i� correct: and that I am the owner, or the duly author-
ized 3Mt 'If the (,%,net. I ipte to comply with city and sia*z laws rrgu-
M'M ON
APPLICATION APPROVAL
bftg consLruction: and in doing the woz), aud-ozired thereby, Be per�on _TT
h cre b ne'
"'o
�7,
will bc am ployed in Yiola tior of the Labor Cede of the S rate o f Wash ington
THIS FIEFIMIT
This application is not a perinit
,,etatinS to Workmen's Compensation Insurance.
AUTHORIZES
until signed by �e Building Official or
NOTE: Fe?nllft LiMit 000 Y8ffrF,.c-pt DBIOL171ONS and FILL
C-M'-y THE
4is Deputy; d fees are paid, and
J�y
co ed
PERIMIMS without conditional use permit, whdch shall be compItted in 90
WORK NOTED
.-eceip, is ticknowledged in space pro.
days; MOVED -IN, BUILDINCS shall be completed in six moriths.)
%ided.
-
SIGNATURE (OWNER OR AGENT)
TIE SIGNEZI
INSPECTION
DEPARTMENT
R R S OCI-T'Urre I
CITY OF
E...N..
AT.
AVOTE: A=r Subject to Plan neck Fee
775-2525
ThillPsmitoevenwo, tobedon on private prulPicty ONLY.
Any owstructlon on thil public darrain (curin, ndar-aft. drivirways,
ORIGINAL - F;le YELLOW - lnsrl,7�'
mvw-as. .1C.) -in —Wire sepant. P �.' .
GOLD - Am"sor PI?JK OWr,e.
41
..............
VNWO
�Xi
�2 x"
ZO N E
SETBACKS:
N S: rt -7
Sc,%le. L"=50'
TANIIAPY Z'% REE A
OTHER
HEIGHT-��-o
z 511.501
ccl�:
Al
"rj
2 q rg,
q 15.50 'v89*on-qs.-i"
C'Ty OF
G I E
-1 G IE7 p y.
, L
Date
ROnlarks
OK
77
Srli��."rl "Zi -
—11. Wotti��ei'
The Cify of Edm--A-
Tt iEET
APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION 0
OWNER
..... F
...........
JOB ADDRESS
- - -------- 4� ----------
REPAIRS E]
EASEMENT NO . .............................
LID NO - ------------------ - ASMT- No . ............
CONTRAC-fOR
NO.
LEGAL DESCRIPTION: LOT NO. BLOCK NO - -----------------------------------
............................ ----------------------------------------------------------------------------------------------- --------- ------- -------------------
NAME OF ADDITION
-pprovea:
By 4
DATE --- 4�
.... ....... ------- --------- --
/ i 1/75
L SIN 1:,
s
qrw.., 15F'E.
10. j ,
J. I
-e 'T
CITY OF EDMONDS SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
4,
%
PERMIT
Call 775-2525 for side sewer inspections BEFORE covering any Portion of the construction
ithin 24 h
(InsPection will be Provided w ours after requst.
NO Sat., Sun., or holiday inspections. J'
ADDRESS LOCATION OF CONSTRUCTION -----
..... . ...............
.................................
. . . ...... L Jf ............
.......................................
PROPERTY LEGAL DESCRIPTION ------------- : -
-!f-5 I , ... �,j r
............. . ...........
............
.............
............................................ ..... . .......... . ........... ................................................................................................................................................................................
z., -:j- 21
. ................................. 'ERAL1%M'/OR BUIMER ......
------------------------ O'V'V'I%
............... . .............................................
------------ ...........
..........
7JMR'S NAME & ADblt
XRAC ESS ............
............................ I -------
................
..... . ... .......................................................
Is granted...
............ .... . ............ for repair
S�, and/Or connection of a side sewer to the city sanitary sewer
In accordance with City of Edmonds ordinances.
ATTENT16N IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the Property may obtain a permit to construct sewer inside Property line. A licensed Side sewer contractor must be employed to construct
side sewer in street area. Do not cover any Portion of sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit Obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top, of side sewer must have at least 30 inches coverage at property line and 12 Inches inside Property line; minimum grade of 2%. No bends in grade
sharper than % will be permitted.
work which may develop within one year of completion. Contractors shall be responsible for failure due to improper
NOTE No. 5—Trenches in street must be water settled and surface of street restored to original condition.
NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED E] Date
--------- - -- --------
.......... ................... By ----------------
"PROVED
.................. By ---------------- Date—
.... ... BY ---------------- Date .....
Date ...... .. :�,
............ %
.. ............. By-
. .......................................................................................
.. ... ...
Remarks: ....... . ...... . ........
T.................. . ... ...................................
------------------- - ------------------------------------ . .............. ........................................
.............
................................................
................
....................................................................
....................................................................
BOTH P Copie! MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
A.
er o Contracting Firm Performing Construction)
........ ................................................. .... hereby certify that the side sewer installation constructed under this permit
was installed in acco ance with all governing ordinances of the City of Edmonds.
—.7
Datedthis ............................ day of ................................................................ 19 ......
V V Che
ck BEFORE you dig for: Water Gas E], 'Telephone 0,
Power E], Sewer
Other E] V N/
7,
r7 -T
APPLICATION
The �City of Edmonds for EASEMENT NO - -------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION E] REPAIRS LID NO - ------------------ - ASMT. NO. --- -------------
OWNER
......................... ------------------------- _ ----------------------
JOB ADDRESS --------
CONTRACTOR ccu ,I & IL
Z5� ----------------------------- ------- PERMIT NO.
----- -----------------
LEGAL DESCRIPTION: LOT NO. --- 2 -------- ------------------ BLOCK NO - ----------------------
__S:� C-->, c.--- ---
----------------------------------------- ------------------------------ ---------------------------------------------------
NAME OF ADDITION ............
Approved:
................. ------------------------------
----------
ci c:
DATE-------------------------------------------- By --------------------------------------------------- YUY6
9 7 f k--1
P!:PT OTC."
T,
Strcet Rxistins, TZI-Qn
Access Fasc;,-.cjits Existin,
% ET'i -UA-
Utility Fascmciit KxistinLa PTOD
Lot Per Suhdiv;sjon<�;- P1 it V-- Assessor 1:ai)
ac�
Situ, 111m (lec.l.cd for Accur,
Pnlcr-rcund Wi-41,i.7 "!C(1(1.
Y=L-
R:alrau 4 1pofd
Existing 1*,'.itcv;'-fnjn Si.-:c
Water."ain !'cf:T!ircd
Hv(Ira:it PCr!"., 1'(,( C4:,(:!C, <�a S. ZC
I-iw
F.
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4ff > /111/
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Catch 11,1,�ili Poalire(l Indicate 6n
CONe :)n In
1-111,lole required oil Site 1"I'm
LI
Nate
Z4�
(Ash
BUILDING DEPARTMENT
PEWIT APPLICATION
Applicant Fill
Inside Heavy Lines
USE PER;T1t4W
ZONE 14UMBER
ADDRESS C)_ 0 C;.
NAME JOR NAME OF BUSINESS)
P1 Ir, H RE IL R _FP_U A A
LEGAL LOT
LOT AREA
SUBDIVISION NO.
W
Z
3:
0
-
MAILING ADDRESS
01 50 81nj
'*yIm NO
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SrREET R/W
!EXISTING STREET R/W 1100 FT. DIEFICIONCY THIS PROPERTY
COMP. PLAN ST. R/W e,,, 0, 'FT. F-r.
CI Y
LynniaoctD, �vq
HLEPHONE NUMBER
774-0 2 a-*-.
W
NAME
REMARKS imtvewa ed tlinse
I L%i L'
U
5a"I"- as
indicated on Standard Drawing #103.
W
W
ADDRESS
CH[CK Eno 'LAY
W
i
k
U
0:
CITY
ELEPHONE NUWBER
STREET AND/OR UTILITY WORK
REQ'D.
IPVES 0 No
R/W PERMIT REQUIRED
42 yes ONO
z
W
NAME
UNDERGROUND
WIRING REQ'D. C3 NO
0
ADDRESS
TYPE CONNECTION UYES
VERIFI ED BY
157 96 tA t,
SANITARY SEWER
NO
I
I& ,
M
I-
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0
CITY
L:—_d-4?677d_j.
TELEPHONE NUMBER
7 7/ --q2 -/ 2
SEPTIC SYSTEM YES
APPV'D BY CITY ENG.
iWNO
'PERMIT NUMBER
tin
STATE LICENSE NUMBER
CITY LICENSE NUMBER
REMARKS
Legal Description of Property (Show Below or Attach Four Copies)
METER SIZETUILDING.SUPPLY
SIZE
N W�e_ ::�7F
W
MARKS
Z
0
I-
IL
jQq c 41E. ICS�TCCI-!2 ZJ
SIGN AREA
ENV. REVIEW
ADB NO.
i
LU4
W
a
6md Its-; C- /0 Tl�'t�taf' h 1�41
ALLOWED PROPOSED
COMPLETE EXEMPT
5J ef Pmr'5-11-77
REMARKS
W
J
pit. tig."uni oF uzi,�ny.� 1.0 Plif,717,n4. goir)
VARIANCE OR CU
PLANNING REVIEW BY
DATE
YARDS
1� 5- FRONT SIDE R E A
RI LOT COVERAGE
rxN RESIDEN . TIAL GAS
EW LINE
ElADD NON-RESIDENTIAL SIGN
F� DEMOLISH RETAINING
WALL
ALTER EXCAVATE FENCE
r-1 F� OR FILL X—F"
FIRE ZONE
TYPE OF CONSTRUCTION IC
ODE
SPECIAL INSPECTOR AREA
REQUIRED
El YES El No
OCCUPANCY
GROUP
I I
OCCUPANT
LOAD
PLAN CHECKED BY TH IS SIT E IS LOCATED IN T H E CITY
PRE -MOVE swim
D REPAIR F-1 INSP. POOL
OF EDMONDS. -LOCAL SALES TAX
SHOULD BE CODED 31.04.
z
W
NUMBER*OF STORIES
NUMBER OF
DWELLING
UNITS
REMAR KS
NATURE OF WORK TO BE DONE
L
W
PLAN CHECK
NO.
VALUATION
FEE
z
0
I-
Z
PROPOSED USE
)- C-5,
Ir
U
UI
W
PLOT PLAN (INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
L
0
W
PLUMBING
HEAT & GAS LINE
0
W
FENCE
>
z
SIGN
RETAINING WALL
0
U
SWIMMING POOL
04b,
00
a
77'..'77
OVEIL-A(,!. 1,1-,'(-Al
All of
thu
NurLh nall'
of [he NuFLh Hill
or the NorLh Hall or IN
QLLArLer oi:
U.1%
Lhc!
SOULheasl_ (,ruarter -or Suction
NUMP"n L
311, 'rotA,:;hjp 21 North, Ranat GNU,
;.
ENCEI'l!
Lhe
J!L-st 891.0
i-t:.
MEPT
the
ML JU I.E.
kor road purposes.
SMULC'.1' To
0---tNCMCnU LU
Snuhnmtsh counq
P.UJJ. NO. I for piwer purpo6es.
I Xyr 1
That portion or LnC North Nalf of the North "jir of the North ralf of the
WuLbCout Q"Pner of Lhe fourbeaq Quhrter of Section 18. Tow-nsnip z1 orth,
Rz1nj,,e 4 raL;t, W.M.
BesinnKs at n point. 00 Lh, South I inn theroof, S 890?""', 20" 1.1 ju.0 rc trom
the SOUtheist Corpor theroor,
b"I"R n Point in the Post_ vor"in of 7617h Avc, W,:
rh,",o aTung the South line S nV024-20" W, a dictapee K 246,47 Lt.; phence
JQ 1034'45- 5, " distance or 82,An Wy thence M 88023131" E parallel to the MorC
line Cherelf a d's"CO OF 50-P ft.; thpnee N 750 E, 6 L11
N 7000'52'' ft. 0.0 ft., N 540 E, 00.0 Ft—
S 1034'06" W a Point On the Wett margin of 76th Ave. W.; thence
voij maypin, a dinvance o r lD3-05 Ft. W the Point of Beginning.
SURTEM Tn an vasunw"( Wo !Ahj""j,jj A," lY P.U.0, No. I For power
"!11'11 Al"'D Tn 114 Interls! Q a privaLe road for Ingrenn,
egrcsN and ucliltleN descrihed
A arip of land 25 ry, In width thr cencurline or hi,h y descrihea a!j
10110WO: Beginning At a PoW on the West margin of 76Ch Ate, W_ s 103406"
in ru, From rhe Intersoct I,),, or -nid ninrl,,in nnd Lhe MorLh loc or the raid Norch
Ha;f Of Lhe North Valf or the North Halt of the f�uarti!r Of Lli(: '--'0ULh-
e�A:;( 0tvirrer; thence alonj said rpmerlinu, S WZY52" W, 73,05 it.,; n 54n W,
now rc,; S 750 W, 60,n fl,; N . Rso?3'21" u, 5ny rt, to the East line of a "T''
Nervice return' area, lyi1q; 10 FL. North nd sa"th or said conterline and zwlt.
In width with adinqmLin "ITI%Sch,curvew ror furhing purpuscN,
1/3 ft. having a radius or
Lor :?
That portion Of the North Ualf uE the North'Hulr of the Nnrth Halt O'f the
Southc�lst (NarLur of the njutheast: Quirter of Suction 1H , Toymnhi.
nnn;e 6 Eant, U,M,, OuscuEbed adrunows: p 27 North,
T',ngtnnInj, I-OinL ;in Elie N,)rth line theyeof, S 88023131" W 30.0 f t. from
l,!orLhca:;jL LhCrL-uF, QW9 a point on the Vest margin Of 76th Am Q.;
LhejjC;:� ;flon,-, the 11jrth 1111C t:barelf, S 88023-Yi" W, 0 Wstanisc of 256.50 ft.;
Lhence S 1"34145" C, V distance of 83,0 ft,; thence N R2023'31" U phrallel. tj
the North line therbal', " dMance of 60,13 ft.; thence M 750 E, N 54"
Co,n rr,; - 7`10"111?" r, 71 n% Fr on . k;.. I - — .
'�ll, 1977
Date 0 .t o b
MEMO TO: John B. Mitchell
Water/Sewer Superintendent
FROM: Richard H. Allen
Assistant City Engineer'
SUBJECT: SEWER CONNECTION CHARCES
Legal Description: Lot 2 - See Attached Legal Description.
oz.-*
Commonly -known as: 1920.9 76th Avenue West.Owner: Truax
Z.F.F. Calculation:
Z.F.F. x $
Lateral x $
Unit(s) x $25 $
S14% IS
L
APPROVED BY:
Leif R. Larson, P.E.'
Director of Public Works
CC: Owner
I
Connection Fee
. (see attached)
Lateral Charge
25.00 Trunk Charge
10.00 Permit
35.00 TOTAL
r
3
.1
5/10/77
'14
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
mkkapd P., �Tukw
MAILING ADDRESS
CITY zip U TELEPHONE
C7
L"I I-) ri W00'-)
NAME
— F:; Q
ADDRESS
CITY ZIP ITEL EPHONE
NAME CBL #
ADDRESS
CITY ZIP TELEPHONE
STATE LICENSE NUMBER
PERMIT EXPIRES 411-1�
USE PERMIT &fo
ZONE NUMBER
JOB SUITE/APT#
ADDRESS I qlo;7 - -7&-04' A VE,� W
PLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
LID FEE S
TESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required
Street Use Permit Req'd
EXISTING _ PROPOSED Inspection Required
Sidewalk Required 4
REQUIRED DEDICATION FT Undergrowd
Wiring required 0
METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES 13 NO 13 3
REMARKS z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z
?'Aut , Vf2_ Qx-��nt I I i v r'� n I
ENGINEERING REVIEWED BY
DATE N
/I , ldffr-
DATE
FIRE REVIEWED BY
EXPIRATION DATE VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
CHECKED BY OnCT.M
PROPERTY TAX ACCOUNT PARCEL NO.
0 _? 0 4 ObA O'C�A C
NEW RESIDENTIZ
ADDITION COMMERCIAL
REMODEL MULTIFAMILY
0 REPAIR E] GRADING CYDS
13 DEMOLISH TANK
GARAGE RETAINING WALL
GARPORT ROCKERY
(TYPE OF USE. BUSINESS OR ACT. LAIN:
NUMBER NUMBER OF 7
OF DWELLING
STORIES UNITS
DESCRIBE WORK TO BE DONE
IOYE��O 1$
SEPA REVIEW SIGN AREA HEIG
COMPIL E EXEMPT ALLOWED PROPOSED ALLOWED, , PROPOSED
EXP I ::�5 P57- 5'
PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
COMPLIANCE OR
CHANGE OF USE a5_V'0 /k
PARKING LOT AREA LANNING REVIEWED BY DAfE
SIGN REO'D I PROVIDED I
FENCE �7_- ; 7- — I /
X FT) REMARKS
OTHER
oF:RE SPRINKLER
F RE ALARM
N
Y �UCX-4p� I �-1 �< 'f 4� lb v I C'_n v) 1) Q ,,
Mff�� 201
HEAT SOURCE GLAZING % LOT SLOPE %
Fill
PLAN CHECK NO.-
3/21 VESTED DATE I
D
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC
0
OMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPILICATION: 180 DAYS
PERMIT UMrP I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNI",' DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S,Q
,ghnNSATION INSURANCE AND RCW 18.27.
SIGNATURI('�(OWNER)IR AGENT) . DATE'SIGNED
I
CHECKEDBY I TYPE OFj ZCNSTRUCTION CODE__ I OCCUPANT
GROUP
—A �7 '�� I it
�'SPECIAL INSPECTION JAREA OCCUPANT
REQUIRED [] YES 1 "7;73 LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D , 9z
IsIn
VALUATION
I
$ (P, �
Description FEE Description FEE
Plan Check 0 1, State Surcharge
Building Permit City Surcharge
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection AX
fire Review PlanChk.Deposft
Fire Inspection Receipt III
Landscapelnsp. Total Amt. Due
Recording Fee Receipt #
APPLICATION APPROVAL
This application Is not a permit Until signed by the
CALL Building Official or his/her Deputy: and Fees are paid, and
FOR INSPECTION receipt Is acknowledged In space provided.
OFFICIALS SIGNATURE 0 TE
(425)
771-0220 'heLEASOAY 'DAT6
ATTENTION
Eff 1333
IT IS UNLAWFUL TO',US.E OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEER,MADE AND APPROVAL OR A CERTIFI- ORI�INAL- ILE YELLOW !INSPECTOR
N GRANTED. UBC SECTION 109 .0
CATE OF OCCUPANCY HAS BEE P I N�JKO E R GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
DATE N
/I , ldffr-
DATE
FIRE REVIEWED BY
EXPIRATION DATE VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
CHECKED BY OnCT.M
PROPERTY TAX ACCOUNT PARCEL NO.
0 _? 0 4 ObA O'C�A C
NEW RESIDENTIZ
ADDITION COMMERCIAL
REMODEL MULTIFAMILY
0 REPAIR E] GRADING CYDS
13 DEMOLISH TANK
GARAGE RETAINING WALL
GARPORT ROCKERY
(TYPE OF USE. BUSINESS OR ACT. LAIN:
NUMBER NUMBER OF 7
OF DWELLING
STORIES UNITS
DESCRIBE WORK TO BE DONE
IOYE��O 1$
SEPA REVIEW SIGN AREA HEIG
COMPIL E EXEMPT ALLOWED PROPOSED ALLOWED, , PROPOSED
EXP I ::�5 P57- 5'
PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
COMPLIANCE OR
CHANGE OF USE a5_V'0 /k
PARKING LOT AREA LANNING REVIEWED BY DAfE
SIGN REO'D I PROVIDED I
FENCE �7_- ; 7- — I /
X FT) REMARKS
OTHER
oF:RE SPRINKLER
F RE ALARM
N
Y �UCX-4p� I �-1 �< 'f 4� lb v I C'_n v) 1) Q ,,
Mff�� 201
HEAT SOURCE GLAZING % LOT SLOPE %
Fill
PLAN CHECK NO.-
3/21 VESTED DATE I
D
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC
0
OMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPILICATION: 180 DAYS
PERMIT UMrP I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNI",' DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S,Q
,ghnNSATION INSURANCE AND RCW 18.27.
SIGNATURI('�(OWNER)IR AGENT) . DATE'SIGNED
I
CHECKEDBY I TYPE OFj ZCNSTRUCTION CODE__ I OCCUPANT
GROUP
—A �7 '�� I it
�'SPECIAL INSPECTION JAREA OCCUPANT
REQUIRED [] YES 1 "7;73 LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D , 9z
IsIn
VALUATION
I
$ (P, �
Description FEE Description FEE
Plan Check 0 1, State Surcharge
Building Permit City Surcharge
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection AX
fire Review PlanChk.Deposft
Fire Inspection Receipt III
Landscapelnsp. Total Amt. Due
Recording Fee Receipt #
APPLICATION APPROVAL
This application Is not a permit Until signed by the
CALL Building Official or his/her Deputy: and Fees are paid, and
FOR INSPECTION receipt Is acknowledged In space provided.
OFFICIALS SIGNATURE 0 TE
(425)
771-0220 'heLEASOAY 'DAT6
ATTENTION
Eff 1333
IT IS UNLAWFUL TO',US.E OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEER,MADE AND APPROVAL OR A CERTIFI- ORI�INAL- ILE YELLOW !INSPECTOR
N GRANTED. UBC SECTION 109 .0
CATE OF OCCUPANCY HAS BEE P I N�JKO E R GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
Y �UCX-4p� I �-1 �< 'f 4� lb v I C'_n v) 1) Q ,,
Mff�� 201
HEAT SOURCE GLAZING % LOT SLOPE %
Fill
PLAN CHECK NO.-
3/21 VESTED DATE I
D
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC
0
OMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPILICATION: 180 DAYS
PERMIT UMrP I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNI",' DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S,Q
,ghnNSATION INSURANCE AND RCW 18.27.
SIGNATURI('�(OWNER)IR AGENT) . DATE'SIGNED
I
CHECKEDBY I TYPE OFj ZCNSTRUCTION CODE__ I OCCUPANT
GROUP
—A �7 '�� I it
�'SPECIAL INSPECTION JAREA OCCUPANT
REQUIRED [] YES 1 "7;73 LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REO'D , 9z
IsIn
VALUATION
I
$ (P, �
Description FEE Description FEE
Plan Check 0 1, State Surcharge
Building Permit City Surcharge
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection AX
fire Review PlanChk.Deposft
Fire Inspection Receipt III
Landscapelnsp. Total Amt. Due
Recording Fee Receipt #
APPLICATION APPROVAL
This application Is not a permit Until signed by the
CALL Building Official or his/her Deputy: and Fees are paid, and
FOR INSPECTION receipt Is acknowledged In space provided.
OFFICIALS SIGNATURE 0 TE
(425)
771-0220 'heLEASOAY 'DAT6
ATTENTION
Eff 1333
IT IS UNLAWFUL TO',US.E OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEER,MADE AND APPROVAL OR A CERTIFI- ORI�INAL- ILE YELLOW !INSPECTOR
N GRANTED. UBC SECTION 109 .0
CATE OF OCCUPANCY HAS BEE P I N�JKO E R GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
fire Review PlanChk.Deposft
Fire Inspection Receipt III
Landscapelnsp. Total Amt. Due
Recording Fee Receipt #
APPLICATION APPROVAL
This application Is not a permit Until signed by the
CALL Building Official or his/her Deputy: and Fees are paid, and
FOR INSPECTION receipt Is acknowledged In space provided.
OFFICIALS SIGNATURE 0 TE
(425)
771-0220 'heLEASOAY 'DAT6
ATTENTION
Eff 1333
IT IS UNLAWFUL TO',US.E OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEER,MADE AND APPROVAL OR A CERTIFI- ORI�INAL- ILE YELLOW !INSPECTOR
N GRANTED. UBC SECTION 109 .0
CATE OF OCCUPANCY HAS BEE P I N�JKO E R GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
771-0220 'heLEASOAY 'DAT6
ATTENTION
Eff 1333
IT IS UNLAWFUL TO',US.E OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEER,MADE AND APPROVAL OR A CERTIFI- ORI�INAL- ILE YELLOW !INSPECTOR
N GRANTED. UBC SECTION 109 .0
CATE OF OCCUPANCY HAS BEE P I N�JKO E R GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING